Fibromyalgia
Chronic widespread pain with fatigue, unrefreshing sleep and cognitive symptoms, diagnosed positively with the 2016 ACR criteria after a few targeted tests. Exercise is the only strongly recommended treatment; low-dose amitriptyline or duloxetine help some, and opioids don't.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Chronic widespread pain with fatigue, unrefreshing sleep and cognitive symptoms ("fibro fog"), lasting at least 3 months. Prevalence is about 2 to 4%, higher in women and in middle age.
- It is nociplastic pain: altered central pain processing without tissue damage or nerve injury to explain it.
- Diagnose it positively with the 2016 ACR criteria after a small set of tests to exclude mimics. Endless investigation reinforces illness beliefs.
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Sources
- Therapeutic Guidelines: Rheumatology (fibromyalgia)AU/NZTherapeutic Guidelines Limited (eTG complete), current online version, accessed November 2026
- Macfarlane GJ et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2017;76:318-28EULAR, 2016 revision (no later EULAR update found on PubMed, November 2026)
- Wolfe F et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016;46:319-29Seminars in Arthritis and Rheumatism, 2016
- Arnold LM et al. AAPT diagnostic criteria for fibromyalgia. J Pain 2019;20:611-28ACTTION-APS Pain Taxonomy (Journal of Pain), 2019
- Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NG193)National Institute for Health and Care Excellence, 2021
- Pharmaceutical Benefits Scheme: pregabalin, duloxetine and amitriptyline listingsAU/NZAustralian Government Department of Health, Disability and Ageing, online schedule, accessed November 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy